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Serum 25‐Hydroxyvitamin D , Transitions Between Frailty States, and Mortality in Older Adults: The Invecchiare in Chianti Study
Author(s) -
Shardell Michelle,
D'Adamo Christopher,
Alley Dawn E.,
Miller Ram R.,
Hicks Gregory E.,
Milaneschi Yuri,
Semba Richard D.,
Cherubini Antonio,
Bandinelli Stefania,
Ferrucci Luigi
Publication year - 2012
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2011.03830.x
Subject(s) - interquartile range , medicine , confidence interval , odds ratio , prospective cohort study , gerontology , cohort study , demography , sociology
Objectives To assess whether serum 25‐hydroxyvitamin D (25( OH ) D ) concentrations relate to transitions between the states of robustness, prefrailty, and frailty and to mortality in older adults. Design The Invecchiare in Chianti (In CHIANTI ) Study, a prospective cohort study. Setting Tuscany, I taly. Participants Adults aged 65 and older (N = 1,155). Measurements Serum 25( OH ) D concentrations measured at baseline; frailty state (robust, prefrail, frail) assessed at baseline and 3 and 6 years after enrollment; and vital status determined 3 and 6 years after enrollment. Results The median (interquartile range) 25( OH ) D concentration was 16.0 ng/mL (10.4–25.6 ng/mL; multiply by 2.496 to convert to nmol/L). Prefrail participants with 25( OH ) D levels less than 20 ng/mL were 8.9% (95% confidence interval ( CI ) = 2.5–15.2%) more likely to die, 3.0% (95% CI = −5.6–14.6%) more likely to become frail, and 7.7% (95% CI = −3.5–18.7%) less likely to become robust than prefrail participants with 25( OH ) D levels of 20 ng/mL or more. In prefrail participants, each 5‐ng/mL decrement of continuous 25( OH ) D was associated with 1.46 times higher odds of dying (95% CI = 1.18–2.07) and 1.13 higher odds of incident frailty (95% CI = 0.90–1.39) than with recovery of robustness. Transitions from robustness or frailty were not associated with 25( OH ) D levels. Conclusion Results provide evidence that prefrailty is an “at risk” state from which older adults with high 25( OH ) D levels are more likely to recover than to decline, but high 25( OH ) D levels were not associated with recovery from frailty. Thus, 25( OH ) D levels should be investigated as a potential therapy to treat prefrailty and prevent further decline.